L.A. Care Health Plan Fined $150K by DMHC Over Claims Payment Issues
The Department of Managed Health Care has levied a $150,000 fine against L.A. Care Health Plan after an audit revealed a pattern of unfair payment practices. The audit found that L.A. Care Health Plan paid the wrong interest payments on seven of 73 claims, giving them a compliance rate of 90%, which is below the state's mandated compliance rate of at least 95%. The audit found the health plan also did not respond in a timely manner to 19 of 93 disputed claims, resulting in a compliance rate of 80%.
- "DMHC Fines L.A. Care $150,000" (Payers & Providers, 1/14).